Waldroup, Joan S

Waldroup, Joan S is an individual health care provider with primary practice located at 1403 43Rd Ave , Gulfport MS 39501-2545. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Waldroup, Joan S can be contacted via phone (228) 234-9460.

Contact Information

Primary practice address
1403 43Rd Ave Gulfport MS 39501-2545
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C6319 Mississippi

Profile Details

NPI number 1457365447
LBN Legal business name Waldroup, Joan S
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Feb 9th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457365447 NPPES
Mississippi MEDICAID 01535581

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